Abstract: Objective To explore the value of isoform［-2］proprostate-specific antigen(p2psa), prostate health index(PHI)and prostate health index density(phid)in the diagnosis of prostate cancer. Methods Clinical data of 148 male patients who underwent prostate biopsy in our hospital during Aug. 2020 and Sep. 2021 were collected. According to the pathological results, the patients were divided into benign prostatic hyperplasia group(BPH, n=78)and prostate cancer group(PCa, n=70). Serum prostate specific antigen(PSA), free prostate specific antigen(fPSA)and p2PSA were determined before prostate biopsy, and prostate specific antigen density(PSAD), PHI and PHID were calculated. Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of various indexes in the diagnosis of prostate cancer. The prostate pathological result was considered as the gold standard to evaluate the Gleason score of PCa patients and detect the value of various indexes in predicting high-grade PCa(Gleason score ≥7). Results Compared with BPH group, the PCa group had significantly higher PSA, PSAD, p2PSA, PHI and PHID(all P<0.001). ROC curve showed that the area under the curve(AUC)of PSA, PSAD, p2PSA, PHI and PHID in the diagnosis of PCa were 0.68, 0.81, 0.83, 0.88 and 0.92, respectively. The diagnostic value of p2PSA, PHI and PHID was better than that of PSA(all P<0.001). The AUC of p2PSA, PHI and PHID in the diagnosis of high-grade PCa were 0.75, 0.84 and 0.84, respectively, which were better than that of PSA(AUC=0.69)(P=0.026, P=0.009, P=0.028). Conclusion Detection of p2psa, PHI and PHID can improve the specificity of prostate cancer diagnosis and accurately predict high-grade prostate cancer. They are significant to evaluate the malignancy, biological behavior and prognosis of the tumor.

Key words: Prostate cancer, isoform［-2］proprostate-specific antigen, Prostate health index, Prostate health index density, Gleason score